Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Introduction: Discharge planning is an important part of the nursing process because it can assist patients and families in preparing for future care at home. Discharge planning that begins from the outset can shorten the length of stay of patients in the hospital, reduce readmission following hospitalization, and arrange for patient discharge on time. Several factors influence the implementation of discharge planning. It is intended that by understanding all the factors that influence discharge planning, the implementation of discharge planning may be optimized. The study aims to determine the factors associated with the implementation of discharge planning in one of the private hospitals in Purwakarta. Materials and methods: The study employed a cross-sectional design with total population sampling. Nurses' knowledge, motivation, education level, and work length were all studied. The study involved 162 inpatient room nurses and critical care rooms. The instrument was an online questionnaire that had been validated and reliable. This study has been ethically approved. Results: Most respondents have a bachelor’s degree (74%), work experience ≤5 years (61%), good motivation (86.4%), sufficient knowledge (64.8%), and good discharge planning implementation (91.4%). The findings revealed a relationship between nurse motivation and discharge planning implementation; however, knowledge, education level, and nurses' work length were unrelated to the implementation. Conclusion: Nurse motivation is critical for successful hospital discharge planning implementation. Hospitals can boost nurse motivation in discharge planning implementation by mentoring, monitoring, and rewarding nurses who perform well.

Background: Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia. Methods: A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes. Results: A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness. Conclusions This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.

Massive calcification of the left atrium (LA), known as coconut atrium or porcelain atrium, is rare. This study emphasized the importance of assessing the extent of calcification in the LA before surgery. We present a case of a 55-year-old woman with severe, long-standing rheumatic mitral stenosis complicated by massive LA calcification. Mitral valve replacement surgery and thrombus evacuation were performed. Calcified LA complicates management, particularly in determining the surgical incision site, and alters atrial wall hemostatic properties while increasing right ventricular afterload. Available diagnostic modalities allow comprehensive preoperative planning for left atrial calcification. These methods identify specific case concerns and variations to optimize outcomes.